The impact of diet and regular mixers on breath alcohol concentration: A comparative study

• Published in: Toxicology letters Vol. 409; pp. 145 - 151
• Main Authors: Avci Akca, Asena, Johnston, Atholl
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2025
• Subjects: 13C acetate test; Adult; Alcohol; Alcohol Drinking - adverse effects; Alcoholic Beverages - adverse effects; Artificially Sweetened Beverages - adverse effects; Breath alcohol concentration; Breath Tests; Cross-Over Studies; Diet; Diet mixers; Ethanol - analysis; Female; Gastric emptying; Gastric Emptying - drug effects; Humans; Male; Middle Aged; Young Adult; Diet mixers; Alcohol; Gastric emptying; 13C acetate test; Breath alcohol concentration
• ISSN: 0378-4274; 1879-3169; 1879-3169
• DOI: 10.1016/j.toxlet.2025.05.009

The use of alcoholic beverages with 'diet' mixers is becoming more popular. The purpose of this study was to assess BrAC and the pace of stomach emptying in healthy volunteers after consuming either sucrose-containing or artificially sweetened alcoholic beverages. This was a two-way crossover trial with an open label. The subjects consumed alcohol on two consecutive occasions conducted in the morning (9:00am-12:00 pm), once with diet coke and once with standard coke. In a randomised order, twelve healthy participants (n = 12, 8 male and 4 female) aged 19–64 years were studied twice. They drank a standardised (0.5 g/kg body weight) volume of vodka (37.5 % ABV) over a time period of 1 minute in each session, prepared with either 'regular' coke with 35 g sugar in 330 mL or 'diet' coke with artificial sweetener which is aspartame. Their BrAC was measured every 15 minutes for 3 hours. Their breath samples for stomach emptying measurement were taken separately in breath bags right after the breath alcohol measurement. The gastric half-emptying time (t1/2) and lag phase time (tlag) characteristics of these breath samples were determined. Diet coke increased both the peak BrAC (38.3 ± 9.45 vs. 34.8 ± 6.82 μg/100 mL) and the area under the breath ethanol curve between 0 and 180 minutes (45249.0 ± 95.7 vs. 40439.25 ± 72.5 μg·min/L). Using nonlinear regression analysis, the diet drink showed a shorter half-emptying time (t1/2) than the regular drink (100.09 ± 35.42 vs. 110.74 ± 66.71 min), while the lag phase (tlag) was slightly longer (49.35 ± 13.52 vs. 46.63 ± 13.90 min)." This study emphasises the need of considering factors other than the alcohol level of a drink when determining safe quantities of intake and the potential of intoxication. The lack of sucrose in diet mixers may cause faster stomach emptying of alcohol, increasing its absorption rate into the blood, resulting in higher peak BrAC and increased exposure to other alcohol-related dangers. •Diet mixers increase breath alcohol concentration compared to regular mixers.•Gastric emptying is faster with diet mixers, influencing alcohol absorption rates.•The study uses a crossover design with randomized drink order for reliability.•Findings suggest diet mixers may elevate intoxication risks even at similar doses.